Factors Associated with Treatment Failure among Smear Positive TB Patients in Khorasan-e-Razavi and Sistan-Baluchistan Provinces, Iran

Yıl 2016, Cilt: 6 Sayı: 4, 172 - 178, 01.12.2016

Hekmatollah Khoubfekr

https://doi.org/10.5799/jmid.328927

Öz

Introduction: Tuberculosis (TB) treatment failure is one of the major problems of the health sector in developing countries.
Poor treatment of patients leads to drug resistance, relapse, death, and ultimately prevents TB control programs.
This study was conducted to determine the factors affecting tuberculosis treatment failure in Khorasan and Sistan- Balochistan
regions which have a high prevalence of TB.
Methods: In this case - control study 270 patients with tuberculosis (90 cases, 180 controls) were analyzed. New TB
patients registered with failure to treatment according to the national protocol between March 2008 - March 2012 were
chosen as cases and new TB patients with negative sputum smear in the same time frame were enrolled as control
group. Demographic data and clinical treatment outcomes were collected through interviews and file records. Multivariate
logistic regression analysis was used to determine the predictors of treatment failure in SPSS 19.
Results: Independent factors and predictors of failure treatment included illiteracy, a three plus positive sputum smear,
positive sputum smear at end of the second month, non-implementation of the Directly Observed Treatment Short
strategy by healthcare staff, history of addiction and history of diabetes.
Conclusion: Intervention programs for early detection and control of diabetes, drug control programs, giving priority to
providing DOTS by health care workers, more individual care and attention to patients with initial smear p + 3 or those
that remain sputum positive at the end of the second month or those who are less educated is necessary. J Microbiol
Infect Dis 2016;6(4): 172-178  

Anahtar Kelimeler

Tuberculosis, Treatment failure, Iran

Kaynakça

• 1. Mirhaqqani L, Nasehi M. National Guidelines for fighting tuberculosis. The Iranian Ministry of Health, Treatment and Medical Education. Center for Disease Management. 2nd Edition, Andishmand Publishers; 2011. Available from: http://tb-lep.behdasht.gov.ir/Tutorial_Documents_Inside.aspx 2. Santha T, Garg R, Frieden TR, et al. Risk factors associated with default, failure and death among tuberculosis patients treated in a DOTS programme in Tiruvallur District, South India, 2000. Tuberc Lung Dis 2002; 6 (9):780-788.
• 3. Bonacci RA, Cruz-Hervert LP, García-García L, et al. Impact of cigarette smoking on rates and clinical prognosis of pulmonary tuberculosis in Southern Mexico. J Infect 2013; 66: 303-312.
• 4. Viswanathan V, Vigneswari A, Selvan K, Satyavani K, Rajeswari R, Kapur A. Effect of diabetes on treatment outcome of smear-positive pulmonary tuberculosis-A report from South India. J Diabetes Complications 2014; 28:162- 165.
• 5. Bahrampour A. Deductive Biostatistics. 1st ed. Vadiat Publishers, Kerman, Iran; 2002.
• 6. Department of TB and leprosy control 2014 [updated 2014 july 16; cited 2014 september 27]. TB situation in the country and world. Available from: http://tb-lep.behdasht.gov.ir/TB_Situation_in_Iran.aspx.
• 7. Singla R, Srinath D, Gupta S, et al. Risk factors for new pulmonary tuberculosis patients failing treatment under the Revised National Tuberculosis Control Programme, India. Int J Tuberc Lung Dis 2009; 13:521-526.
• 8. Jianzhao H, van den Hof S, Lin X, Yubang Q, Jinglong H, van der Werf MJ. Risk factors for non-cure among new sputum smear positive tuberculosis patients treated in tuberculosis dispensaries in Yunnan, China. BMC Health Ser Res 2011; 11:97.
• 9. Namukwaya E, Nakwagala F, Mulekya F, Mayanja-Kizza H, Mugerwa R. Predictors of treatment failure among pulmonary tuberculosis patients in Mulago hospital, Uganda. Afr Health Sci 2011; 11:105-111.
• 10. Jha UM, Satyanarayana S, Dewan PK, et al. Risk factors for treatment default among re-treatment tuberculosis patients in India, 2006. PLoS One 2010; 5(1):e8873.
• 11. Morsy A, Zaher H, Hassan M, Shouman A. Predictors of treatment failure among tuberculosis patients under DOTS strategy in Egypt. East Mediterr Health J 2003; 9:689-701.
• 12. Adineh H, Motametdi B, Veisi M, Bagheri S. Risk factors of tuberculosis treatment failure in South-East of Iran. J Gorgan Un Med Scien 2014; 16(2):50-56.
• 13. Shibin S, Sivakumar R, Sajeeth C, Abdulla A, Kumar S. A case control study on clinical characteristics and treatment outcomes in tuberculosis with diabetes in Palakkad District. Intern J Research Pharm Chemist 2014, 4(4):863-867.
• 14. Dooley KE, Lahlou O, Knudsen J, Elmessaoudi MD, Cherkaoui I, El Aouad R. Risk factors for tuberculosis treatment failure, default, or relapse and outcomes of retreatment in Morocco. BMC Public Health 2011; 11 (1):140.